PSYCHOSOCIAL IMPACT OF NARCOLEPSY

Despite remarkable progress in our understanding of narcolepsy, the di sease continues to cause the sufferer severe negative life effects. Be fore and after diagnosis, narcoleptics often experience unrelenting se vere psychosocial stress. Child and adolescent narcoleptics report emb arrassment, academic decline and feelings of loss of self-worth relate d to the symptoms of their disease. Personality characteristics may be adapted in order to avoid social situations that would precipitate ca taplexy or draw attention to the patient's degree of somnolence. Misdi agnosis of these illnesses may result in inappropriate treatment and u nderestimation of an individual's potential. Adult narcoleptics also f ace the concerns of the workplace. Worry about loss of job and income are a source of anxiety and are often based in reality. Accidents at h ome, while driving and in the workplace are increased, creating safety concerns for both the patient and the community. Marital difficulties are common and psychopathology is known to occur more frequently. Nar colepsy's marked impact on quality of life has been found to be simila r across cultural lines and these effects appear to be an inherent par t of the disease. The socioeconomic impact in general is even more sev ere than those of comparable forms of epilepsy. Successful diagnosis a nd treatment do not end the narcoleptic's difficulties. The need for s timulants often creates problems with pharmacists and family. Somnolen ce, which responds the most poorly of all narcoleptic symptoms, leads to continued problems in the workplace. Side effects related to stimul ant use may be a further source of difficulty. Finally, families may b e unwilling to accept the illness and thereby alienate the patient. Ed ucation of the public, including physicians, pharmacists and family, w ill be necessary to improve this situation. Participation of informed professionals at the individual and group levels will be necessary to impart positive change in the narcoleptic's psychosocial well-being.